Tier 2: Compliance and Standards
Right Support Right Care Right Culture: A Complete Guide for Care Providers
The Care Quality Commission (CQC) has fundamentally reshaped how it inspects learning disability and autism services. At the heart of this transformation sits Right Support Right Care Right Culture, a framework that goes beyond tick-box compliance to examine whether services truly meet the needs of people with learning disabilities and autistic people.
This guide explains the framework, shows how CQC applies it during inspection, and gives you practical steps to embed it throughout your organisation.
What Is Right Support Right Care Right Culture?
Right Support Right Care Right Culture is the assessment framework published by the CQC in 2022 specifically for services that support people with learning disabilities and autistic people. It replaces the previous assessment framework with a more nuanced approach that recognises the complexity and individuality of these service users.
The framework consists of three interconnected pillars that work together to create truly person-centred, high-quality services. These pillars form the lens through which inspectors evaluate every aspect of your service, from governance and leadership to direct care delivery and environmental standards.
Understanding the Three Pillars
Right Support centres on person-centred care, skilled staff, and maximising independence and community inclusion
Right Care means evidence-based, high-quality, safe care that is personalised and regularly reviewed
Right Culture reflects leadership that empowers people and staff, openness, transparency, and genuine choice and control
The framework directly relates to key regulatory requirements under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 9 requires person-centred care, and Regulation 17 requires good governance. Right Support Right Care Right Culture operationalises these requirements in a way that is specific to learning disability and autism services.
Why Right Support Right Care Right Culture Matters for CQC Registration
For learning disability and autism services, this framework has become the primary assessment tool. Whether your service operates as supported living, domiciliary care, or residential care, CQC uses Right Support Right Care Right Culture to determine whether you are Safe, Effective, Caring, Responsive, and Well-led.
Services that consistently achieve Outstanding ratings demonstrate that they have embedded this framework into their culture and practice. This means people who use their services experience genuine choice, staff are empowered to innovate and take decisions, and there is a genuine commitment to continuous improvement based on people's feedback.
How the Framework Connects to CQC Inspection
CQC inspectors use 34 quality statements to assess your service against the three pillars
Each quality statement maps to specific regulatory requirements and the CQC assessment framework
Inspectors look for evidence across five categories: People's Experience, Feedback, Processes, Outcomes, and Observation
The framework applies to all Key Lines of Enquiry (KLOEs): Safe, Effective, Caring, Responsive, and Well-led
The Three Pillars Explained
Right Support
Right Support means that care and support are tailored to the individual needs, preferences, and goals of each person. This pillar is fundamentally about recognising the person rather than treating them as a service user slot.
In practice, Right Support means:
Person-centred planning that is genuinely led by the individual, their family, and their advocate
Goals that matter to the person, whether these are related to independence, community inclusion, employment, relationships, or simply enjoying life
Staff who are trained and competent in positive behaviour support, autism awareness, communication needs, and person-centred practice
Genuine choice in how care is delivered, when it is delivered, and who delivers it
Regular review and adjustment of support based on how the person is progressing towards their goals
CQC inspectors assess Right Support by asking: Are people genuinely supported to be as independent as possible? Do people have meaningful control over their support? Are staff trained and skilled in understanding the person's communication needs and individual requirements?
Right Care
Right Care means that the care and support provided is safe, effective, based on evidence, and personalised. It is not about over-protection or restriction; it is about enabling people to take appropriate risks whilst managing genuine safety concerns.
In practice, Right Care means:
Personalised care plans that identify individual needs, risks, and the support required to meet these needs safely
Risk assessments that enable rather than restrict; risk management plans that use the least restrictive approach
Effective medication management with regular review and monitoring
Health action plans and annual health checks to ensure physical and mental health needs are identified and addressed
Multidisciplinary working with community nurses, psychiatrists, GPs, and other health professionals
Regular supervision and appraisal for staff to ensure they are developing their skills and knowledge
Systems to identify, report, and learn from safeguarding concerns, incidents, and complaints
CQC inspectors assess Right Care by asking: Are people genuinely supported to be as independent as possible? Do people have meaningful control over their support? Are staff trained and skilled in understanding the person's communication needs and individual requirements?
Right Culture
Right Culture is perhaps the most challenging pillar to embed, because it requires genuine cultural change rather than policy change. It means that the organisation genuinely values and empowers both people who use services and the staff who support them.
In practice, Right Culture means:
Leadership that is visible, approachable, and genuinely committed to the principles of Right Support Right Care Right Culture
Staff who feel valued, supported, and supervised; who have opportunities to develop and progress
An open, inclusive, and transparent culture where people feel safe to raise concerns or feedback
Systems for capturing the voices of people who use services, their families, and staff in service planning and improvement
Governance arrangements that ensure learning from incidents, complaints, and feedback leads to real change
A commitment to continuous improvement based on data, feedback, and reflection on practice
Transparent communication about what the service can and cannot do, and genuine honesty about performance
CQC inspectors assess Right Culture by asking: Do people and staff feel genuinely valued? Is there evidence of learning and improvement? Are concerns taken seriously and acted upon? Is governance robust and transparent?
How to Start a Supported Living Service
Planning a supported living service? Learn what CQC expects, how to structure your service, and the steps to get registered and operational.
How CQC Assesses Right Support Right Care Right Culture
CQC uses a specific assessment framework when inspecting learning disability and autism services. Understanding how this framework operates will help you prepare your service effectively.
The 34 Quality Statements
CQC has developed 34 quality statements specifically for learning disability and autism services. Each statement defines what excellence looks like for that area of care. The statements are grouped under the five Key Lines of Enquiry: Safe, Effective, Caring, Responsive, and Well-led.
Each quality statement maps to one or more of the three pillars. For example, the quality statement on person-centred planning directly relates to Right Support, whilst the statement on safeguarding relates to both Right Care and Right Culture.
Evidence Categories
During inspection, inspectors look for evidence across five categories:
People's Experience: Speaking with people who use services, their families, and advocates about their experience
Feedback: Reviewing survey data, complaints, compliments, and feedback from multiple sources
Processes: Examining policies, procedures, training records, and governance systems
Observation: Watching staff interacting with people, observing the environment, and seeing how the service operates day-to-day
A strong inspection performance requires evidence across all five categories. A service with excellent policies but poor practice, or a service where people are happy but governance is weak, will not achieve an outstanding rating.
Compliance Auditing and Quality Assurance
Already registered but want to stay ahead of CQC? Our compliance auditing service provides mock inspections, evidence reviews, and ongoing quality assurance to keep your rating on track.
I Statements and We Statements
The quality statements use 'I' statements for the person using services and 'We' statements for staff. For example, one quality statement might be 'I am supported to live a full life and be part of my community' (I statement) and 'We enable people to live a full life and be part of their community' (We statement).
This language reflects the person-centred philosophy of the framework. It shifts focus from what the organisation does to what the person experiences.
Common Mistakes Providers Make
Understanding where many providers stumble can help you avoid the same pitfalls.
Treating the Framework as a Checklist
The most common mistake is treating Right Support Right Care Right Culture as a compliance checklist. Providers create policies that tick the box, ensure they can point to evidence during inspection, but do not fundamentally change how the service operates or how people are supported.
To avoid this, ensure that every policy, procedure, and decision is genuinely driven by the principles of the three pillars, not by what you think CQC wants to see.
Over-Restrictive Practices Disguised as Risk Management
Some providers interpret risk management as restriction. They limit where people can go, who they can see, or what they can do, justifying this as risk management. This directly contradicts Right Care, which requires risk management that enables rather than restricts.
CQC will challenge over-restrictive practices and will look for evidence that less restrictive approaches have been considered and why they were not suitable for the individual.
Lack of Community Access and Meaningful Activities
Services that focus on in-house activities and do not facilitate community access will struggle to demonstrate Right Support. People need to have genuine opportunities for community inclusion, whether this is employment, education, leisure activities, or simply having access to the community.
Staff Without Specialist Training
Staff who do not understand autism, learning disabilities, positive behaviour support, or communication needs cannot deliver Right Support Right Care. Investment in training is not optional; it is essential.
Failure to Capture People's Voices
Services that do not systematically gather the views of people who use services, their families, and staff will not demonstrate Right Culture. You need robust mechanisms for gathering feedback, analysing it, and making changes based on what you hear.
How to Prepare Your Service
Preparation for CQC inspection should be ongoing, not something you do in the three months before inspection. However, if you have not yet started, here is how to begin.
Conduct a Self-Assessment
Use the 34 quality statements to audit your current practice. For each statement, rate your service on a scale from 1 (not yet in place) to 4 (fully embedded). This will identify your areas of strength and the areas that need development.
Develop an Action Plan
For each area of weakness, develop a specific, measurable action plan. Do not try to fix everything at once. Prioritise the areas where change will have the greatest impact on people's experience and safety.
Invest in Specialist Training
Ensure all staff have training in positive behaviour support, autism awareness, communication needs, and person-centred practice. Consider accredited training programmes where available.
Create Robust Evidence Folders
Organise your evidence in a way that makes sense to an inspector. Create folders for each quality statement with examples of how your service meets that statement. Include policy documents, training records, people's care plans, feedback, outcomes data, and staff supervision records.
Engage People and Families
Involve people who use services, their families, and advocates in planning and delivering the service. This is not just good practice; it is essential for demonstrating Right Culture.
How Care Sync Experts Can Help
Care Sync Experts specialises in supporting learning disability and autism services through CQC inspection and registration. Our services include:
Guidance through the registration process, from application to first inspection
aligned to Right Support Right Care Right Culture: Comprehensive policy templates that reflect the framework
Mock inspections:
Full or focused mock inspections that test your readiness against the framework
Staff training:
Bespoke training on the three pillars, person-centred practice, and CQC expectations
Evidence folder development:
Help organising and presenting your evidence in a way that clearly demonstrates compliance
CareSync Expert
Need more clarity?
If you are registering a new service or preparing for CQC inspection, contact Care Sync Experts today. Our team has extensive experience in supporting learning disability and autism services to not just pass inspection but to achieve outstanding ratings.
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